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It used to be that unvaccinated children in America were clustered in impoverished neighborhoods; now they’re often clustered among sophisticates in gilded ZIP codes where a certain strain of health faddishness reigns. According to a story in The Hollywood Reporter last year, the parents of 57 percent of the children at a Beverly Hills preschool and of 68 percent at one in Santa Monica had filed personal-belief exemptions from having their kids vaccinated. Why? Many of them buy into a discredited theory that there’s a link between the MMR (mumps-measles-rubella) vaccine and autism. (Frank Bruni, 1/31)

Is measles “benign”? The Centers for Disease Control and Prevention says measles “can lead to severe complications and death” and “even patients who experience uncomplicated acute measles have a small risk for developing a devastating neurologic illness . . . years after their infection.” Measles is common elsewhere in the world, with about 20 million cases reported each year and 122,000 deaths. Before vaccination began in 1963, about 3 million to 4 million people got the disease each year in the United States, of whom 400 to 500 died, 48,000 were hospitalized and 4,000 developed brain swelling. That does not fit our definition of benign. (1/31)

There is a secret that people outside of Washington, D.C., aren’t aware of right now: Some Republicans in Congress are on the verge of proposing an alternative to Obamacare that imposes new tax hikes on the American people. ... The reality is that while Beltway insiders in the elite salons of Washington can do and say whatever they want, the American people know better. A majority of voters — and even larger majorities of conservative and Republican voters — believe that “any replacement of Obamacare must repeal all of the Obamacare taxes and not just replace them with other taxes.” In other words, the voters won’t be fooled by quasi-liberal health plans masquerading in conservative clothing. (La. Gov. Bobby Jindal, 2/1)

Regulators in several states have raised concerns that these ministries offer the illusion of insurance while sidestepping the Affordable Care Act’s baseline standards of coverage and skirting requirements that apply to conventional insurance companies, like minimum cash reserves. Nonetheless, membership in the ministries has been growing, particularly since the act granted them an exemption as one of the only ways to avoid the law’s mandate to buy insurance without paying a fine. But the debate over consumer protections may disguise a more interesting question: Could this model scale up? These ministries seem to achieve a remarkable level of member satisfaction, even if they sometimes must portion out reimbursements when the bills outstrip monthly contributions. (Molly Worthen, 1/31)

The personalized medicine initiative that President Barack Obama announced on Friday was previewed in the State of the Union address and is scheduled for inclusion in the budget to be released Monday. But in devoting federal funds to this, the administration may have made an argument against another type of medical research funded as part of Obamacare. (Chris Jacobs, 2/1)

Gov. Bill Haslam ... announced right before Christmas that he had a verbal commitment from the Obama administration to expand Medicaid subject to some changes. But Mr. Haslam’s announcement was only the first step. Thanks to a law passed last year, Tennessee lawmakers must sign off on any expansion of Medicaid. ... Tennessee lawmakers must decide if they are going to burden more state residents—and American taxpayers—with ObamaCare’s broken promises, failed schemes and unsustainable policies, or whether their state will lead the march toward more freedom, greater access, and better health outcomes. With several other red states including Utah, Wyoming and Montana waiting in the wings on Medicaid expansion, what Tennessee does next week could have implications far beyond the state’s borders. (Christie Herrera and Justin Owen, 1/30)

The Montana Legislature has the opportunity to do more good for our state at less cost than will be available for decades. All we need to do is accept funds to which our citizens are entitled through Medicaid expansion to establish a Montana-based privately run health insurance program. As a 30-year investment professional, I find the business and financial benefits of expansion to be remarkable. Much attention has been focused on the 70,000 Montanans who would be provided healthcare coverage. Largely overlooked in the discussion is the fact that all Montanans will benefit through a stronger economy, substantial job creation, a more secure healthcare system, and a reduction in the costs we all pay to care for the uninsured. (Mark Semmens, 2/1)

The Pentagon budget is $496 billion, which sounds like a lot of money, and it is — until you take account of the fact that an increasing share goes not for weapons, training and readiness but for health care and pension benefits of former service members. ... Now comes the Military Compensation and Retirement Modernization Commission, a blue-ribbon panel established by Congress in 2013, with the latest package of proposed reforms. The panel has clearly done its homework, as demonstrated by the sheer mass of its 302-page report. In one respect, however, its work disappoints: The panel recommends no change to the so-called Tricare for Life program, essentially a free Medigap plan for military retirees age 65 and older that the CBO has repeatedly identified as a major cost center — and which is all but untouchable politically. ... More encouraging was the commission’s proposal to revamp the versions of Tricare that apply to the families of active-duty personnel and working-age retirees. (1/30)

An enduring injustice was supposed to end on Jan. 1. That was the effective date for new rules by the Labor Department that would have required employers of home care aides for the elderly and disabled to pay at least the federal minimum wage and time and a half for overtime. Specifically, the new rules would have ended a federal regulation from 1974 that labeled home care aides “companions,” a designation that lets their employers — generally, for-profit agencies — ignore basic labor protections. (1/31)

Representatives from the United States and 11 other Pacific Rim countries convened to decide the future of their trade relations in the so-called Trans-Pacific Partnership (T.P.P.). Powerful companies appear to have been given influence over the proceedings, even as full access is withheld from many government officials from the partnership countries. Among the topics negotiators have considered are some of the most contentious T.P.P. provisions — those relating to intellectual property rights. And we’re not talking just about music downloads and pirated DVDs. These rules could help big pharmaceutical companies maintain or increase their monopoly profits on brand-name drugs. (Joseph E. Stiglitz, 1/30)

Michael was receiving state-of-the-art treatments at a renowned cancer center in New York City. As he became sicker, the treatments got more intense. Each decision came with more difficult trade-offs and uncertainties. Each step to stay alive risked making things worse. He knew it. We’d talked openly about it. His life was precious and worth fighting for, so every option was worth carefully considering. But modern medicine has yet to make even one person immortal. Therefore, at some point, more treatment does not equal better care. (Ira Byock, 1/31)

Think about it: Faced with mass unemployment and the enormous waste it entails, for years the Beltway elite devoted almost all their energy not to promoting recovery, but to Bowles-Simpsonism — to devising “grand bargains” that would address the supposedly urgent problem of how we’ll pay for Social Security and Medicare a couple of decades from now. (Paul Krugman, 2/2)

Donald Hall, 86, a former poet laureate, probably captured the general mood when he wrote that nursing homes are “old-folks storage bins” and “for-profit-making expiration dormitories.” He wants to die in his farmhouse in New Hampshire. But I think that sounds pretty lonely. I wouldn’t mind going into a nursing home and not coming out. In due time, thank you. I’m 64. (Bert Stratton, 2/2)